Kathleen H Dominguez, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA17714 Issued in CA

Practice address

477 N El Camino Real Ste B105
Encinitas, CA 92024-1330

Phone

(760) 753-7143

Fax

(760) 753-7114

NPI assigned

Aug 30, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kdominguez19478@scrippshlth.medalliesdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Scripps Health

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Rady Children'S Hospital San Diego

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • San Diego, CA
  • NPI 1851303994
  NPD (past)
• Scripps Health

  • Clinical Medical Laboratory
  • La Jolla, CA
  • NPI 1427034990
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572220800000",
    "number": "1689784530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "760-753-7143",
            "fax_number": "760-753-7114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 N EL CAMINO REAL STE B105",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920241330",
            "telephone_number": "760-753-7143",
            "fax_number": "760-753-7114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMINGUEZ",
        "first_name": "KATHLEEN",
        "middle_name": "H",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2019-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "PA 17714",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA17714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena A Dolgonos, MD
• Dolores L. Fazzino, RN, a Professional Nursing Corporation
• Shannon Renee Dolphin, L.AC.
• Cathleen Domingo-Nguyen, DDS
• Ashley Domingo
• Ashley Dominique, PA-C
• Denise Donar
• Lauren Donnelly, D.O.
• Margaret Dooner, L.AC.
• Tanya Cornwell Dorocak, M.A., LMFT

• Physician Assistant in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.